| Iodine is one of the essential micro elements which can cause goiter for inappropriate intaking and is called intellectual element. On a worldwide basis, iodine is the most important preventable cause of brain damage. It is also an essential material required for thyroid hormone synthesis which participate several human normal growth and development progress. Inhabitants who live in a low level of iodine in environment may get thyroid diseases the main manifestation of which is goiter due to inappropriate absorbtion of iodine. Goiter can be assessed by palpation or by ultrasound. Ultrasound is widely used to study and assessment goiter because it is more directive and sensitive than palpation which can be easily affected by subjective factors. Iodine deficiency once was quite serious in our country. To eliminate iodine deficiency universal salt iodization was accepted since 1994 which has obtained much extraordinary achievement. The increasing reports of goiter on clinical recall the relationship between goiter and iodine nutrition a new focus.In order to investigation on status of children s nutrition of iodine, prevalence and impact of goiter, expriments were carried out as well as local investigate in Shanghai Minhang District by multi-stage cluster sampling method. Morning urine and family salt samples were collected and then tested to combine with questionnaire and volume for analysis.As follows,Part I Investigation on status of iodine levels of school aged children in Shanghai Minhang DistrictA total of 996 urine and 963 salt samples were collected and then tested from 2012 and 2013 to learn the distribution of urinary, intaking of salt and the mutually relationship between these two. There’s no difference about distribution in years, genders and ages. The median urinary iodine level for all participants was 143.28ug/L in 2012 and 133.07βg/L in 2013, respectively, total average was 138.11μg/L.The median urinary iodine level was no significant difference among ages and genders in 2012.The mean level of urinary increased with age in 2013 and no significant difference with genders. Students with the urinary iodine lower or higher than recommended level accounted for 27.1% and 27.5%, quite well for 45.4% in 2012,32.1%,19.8% and 48.1% in 2013 respectively. The classification about urinary in these two years has significant statistical difference(x2=27.6, P<0.05)The average level of salt iodine was 21.06mg/kg in 2012 and 21.39mg/kg in 2013. Only 79.09% and 88.67% salt samples were iodized in each year, among which only 71.43% and 74.1% was qualified iodized salt. Iodized salt or not accounted for urine iodine level and has statistical difference (x 2=6.02, P=0.04), (x2=6.78, P=0.03)The status of iodine nutrition in school aged children in Minhang was diverse but the average level for these students was fairly well. The coverage of qualified iodized salt was low and affected the level of urinary iodine, so salt can be used to rightful urinary iodine.Part Ⅱ Distribution of thyroid volume among school aged children in Shanghai Minhang District,2013The mean and median of thyroid volume was 4.98ml,4.75ml respectively. There was no significant difference of median values between genders (T=-0.248, P=0.804),4.75ml in boys and 4.76ml in girls. There volume increased with ages(H=31.74, P<0.001). The 97% of thyroid volume from 8 to 11 was 7.59ml,8.47ml,8.56ml and 8.84ml and all were higher than our country recommend. The median value of HVI, BMIV, WHVI and BSAV was higher in girls than boys and the value increased with ages. The lowest value of HVI, BMIV and BSAV appeared in urinary appriate group. The lowest value of BMIV was in the group of qualified salt. The prevalence of goiter was lower by Chinese standard than by WHO standard. Weight, HVI, BMIV, WHVI and BSAV was difference in goiter or not, while urinary iodine and salt iodine has no difference.The thyroid volume among school aged children in Shanghai Minhang District was higher than recommend. The BSAV can rationally reflect the distribution of thyroid volume, this need further investigate to confirm. Part Ⅲ Analysis on influential factors of goiter among school aged children in Shanghai Minhang District in 2013The prevalence of goiter was 30.83%. Genders had no influence on goiter rate which was 34.6% in boys and 26.5% in girls. The rate of goiter had negative correlation with ages and this had statistical difference (x2=13.47, P<0.001). The relationship between salt iodine and goiter was statistical difference(x2=8.49, P=0.004). The coefficient was 0.382 between goiter and seaweed. There was no significant difference of family structure, parental education, ratio of food expenditure, household income, aquatic food, personal consumption of salt, seafood consumption, cruciferous vegetables, menarche and history of thyroid diseases with goiter.The high prevalence rate of goiter was affected by ages, salt, seaweed, iodized measures need to be continued and enhanced with other comprehensive measures. |
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